Family Med Medical News about acute myocardial infarction;treatment and outcome;gender

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Treatment and outcome in acute myocardial infarction in a community in relation to gender
International Journal of Cardiology, 07/01/09

Herlitz J et al. – In the Göteborg community, women (mean age 79 yrs) with acute myocardial infarction (AMI) are prioritized differently than men (mean age 72 yrs), prior to coronary care unit (CCU) admission, which results in a less invasive strategy in women, particularly for coronary artery bypass grafting (CABG). When adjusting for difference in age, admittance to CCU and coronary revascularization female gender was associated with a low risk of death during the subsequent 3 yrs.

Methods

Study of treatment and outcome in all pts in a community with AMI in relation to gender
Survey of all AMI pts discharged from hospital 2001-2002 in Göteborg, Sweden, for possible gender differences

Results

Of 1423 admissions, women comprised 41%; older women vs men (mean 79 vs 72 yrs)
Women admitted to CCU less frequently than men (49% vs 67%)
Women had coronary angiography less frequently (21% vs 40%)
Percutaneous coronary intervention (PCI) in 10% of women vs 18% of men
CABG in 2% of women vs 9% of men
Female gender associated with lower risk of reinfarction during first year after hospital discharge (12% vs 16%)
Cumulative 3-yr mortality 49% in women vs 41% in men
On adjustment for age, admittance to CCU, coronary angiography and coronary revascularization, risk of death during 3 yrs lower in women vs men

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